A number of factors influence how medicines are used in each community, but drug registration is the initial and usually necessary step. In the course of an external advisory consultation, the list of approved medicines in Peru in 1998 was examined. Of 1672 newly approved forms, 119 were of 49 new chemical entities. Sildenafil, meloxicam, nimesulide, candesartan, irebesartan, naratriptan, trovafloxacin and grepafloxacin were among them. Several aspects about the new global drug situation and 'real' health needs versus 'induced' health needs are discussed from this example. Copyright © 2002 John Wiley & Sons, Ltd.